I am a Junior Doctor about to go on strike, ask me anything.

[Lauralaaaa]

I am a Foundation year 1 doctor who started in the NHS in August. I have been reading some things online and have seen some quite differing opinions. I wondered if anyone had any questions.

I get it and this stuff still gets to me even though the real impact is very low

@Hollyhead @Lauralaaaa

again, I do think that the working conditions sounds horrible. But in terms of the pension, I have just looked this up.

Doctors get 1/54 annual salary in defined benefits. This means that every year, 1/54th gets paid annually for the rest of their lives after they retire (indexed up for rates /inflation I am pretty sure).

so, assuming average salary across life life of £76,000 (internet), working 35 years, gives an annual pension. Of (£76,000 x 35) / 54 = £49,259 in defined benefit. Assumed value of this pension pot is 20 x the annual salary which is £985,185. That is a pension pot most people only can dream of. Coming from the private sector, my pension savings are almost non-existent.

I think the solution may be to let the junior doctors opt out of their pension contributions completely. I would be surprised if this didn’t add to about 20% pay increase and also be cheaper for the taxpayers in the long run. They could opt back in when they are more senior.

@fissty absolutely. Especially if one adds in the job security.

@Lauralaaaa you do realise that other professions regularly work 70 plus hours pw? DH was a barrister so self employed. He had to pay his chambers' fees, clerk, his own pension, and life insurance and got no paid holiday. When he had first finished his pupillage in the mid 80s he could barely pay his rent in a shared house and eat. At 61 and no longer self employed it isn't unusual for him to pull a 50+ hour week.

I have a professional role in a quasi public sector organisation. At 62 I regularly work 45/50 hour weeks. In my 20s in the City 60+ hours weren't unusual during weeks we didn't pull an all nighter because of a deal.

My DC are now 28 and 24; they have professional roles. They both get in an hour early and leave an hour late just to get their jobs done. DS is on £35k - has a PhD; dd on £28k.

Why is it that medics appear always unable to take on board what others do and have no understanding that conditions are comparable but their job security and other benefits in the round are far better over a lifetime.

I have a hospital appointment on Tuesday. Fir the last two appointments the consultant has run 1hr 45 minutes late. No apology, no explanation. I left the last appointment because I had only allowed for a 1hr 30minute delay. If other professionals behaved like that towards stakeholders they would be dismissed. In the NHS it's all part of the toxic culture.

Clearly some of the problem is pay and culture - I don't disagree with that.

But I can't think of another profession that effectively recruits almost all of its workforce at 17. It is striking how many people settle on medicine in their early teens, much like you because they are good at science and want to help people, but are poorly prepared for the reality of the job. Do you think the way the UK does medical training and admission to medical degrees is contributing to the outflow of junior doctors? Would it be better to make medical degrees entirely postgraduate, as well as expanding routes into medicine from nursing, so that people can choose medicine with a bit more maturity under their belt?

Its because we have ops managers like @fissty who insist the clinics are overbooked depsite repeated protestations.

20% employer pension? Blimey thats high. Do nurses get this too?
Private small companies it's nothing. Matched if you are lucky.
Plus the hours of no lunch start early and leave late are normal in the city. Not saying that's right, but it's not abnormal at all.

It’s not a race to the bottom, and fisstys attitude to managing staff is part of the problem. Get rid of that management mentality and a lot of the low morale would disappear as well.

Waiting now for the phone call to tell me my hysterectomy for cancer currently scheduled for 13th March to be cancelled.
Whilst I understand the strikes it's now fucking personal! You are actively choosing to risk my life by striking. I'm sorry but you are. I'm bleeding heavily every day. I'm exhausted by it and by trying to work enough to survive four weeks off after. I'm self employed so no sick pay. All work been suspended and reallocated so if surgery doesn't go ahead I can't just go back to work!
I can't afford it! I will end up eating from a food bank - only I won't be able to fucking get there as I won't be able to drive and there's no public transport here.

@FixTheBone my first comment above should have been to - @HooverIsAlwaysBroken rather than fissty

But why are you being nasty to Fissty. It's Fissty having to make difficult calls because doctors are going on strike. Perhaps the Dr's should be made to make the calls.

@justgettingthroughtheday I really hope it isn't cancelled for you. . If it is, please let the op know although I doubt they or any other strikers will be ashamed of themselves.

@SleekMamma nurses get a 23% employer contribution.

Just to be clear I don’t begrudge the pensions but they clearly muddy the water re compensation as they’re about 150-200% more generous than a ‘good’ pension elsewhere. It’s why senior drs then run into problems with tax bills as their pension pots hit 1m+ mid career.

Would love to make the calls, but it was taken out of our hands years ago. I have literally no say about what happens on my waiting lists, I'm not even able to see them to know how many patients I have waiting, how long, or for what.

And I'm being nasty, because, as evidenced by comments on other threads, they seem to be either living in some fantastic utopia that bears no resemblance to the overwhelming majority of the NHS, or, they just hate medics, hard to tell which.

@justgettingthroughtheday I am so sorry, I hope you still get your operation. 💐.

@Hollyhead I completely agree. I don’t begrudge the pensions at all. I do think that we should be open about the total value of the compensation though.

I also think that junior doctors should be allowed to opt out of the golden pension in return for a much higher salary now. They would then be much higher compensated that most other professions (I think) and still not worse off than anyone in the private sector.

@Lauralaaaa would that be a solution you could be happy with?

May I assume then @FixTheBone that when a patient has been kept waiting for nearly two hours in one of your clinics that you apologise?

My experience of orthopaedic outpatients is not far short of horrific in the UK. In 2004 (DS), 2008 (DD) and me (2015). The previous two were after emergency surgery and each time I shifted into the private sector for the remaining follow ups where at least staff were polite as well competent. It was no worse in 2015 than during the supposed halcyon days of the Blair government.

I totally get your frustration, but not striking would also damage people's health. The NHS is so badly staffed, it's dangerous. Something has to change.

I work in the Australian public system. You could not pay me enough to work for the NHS.

I think that’s Steve Barclays fault. He can avert strike action but he won’t even meet with them. What do you expect the doctors to do

Absolutely I do.

I explain that it takes about 20-30 minutes to assess, investigate and diagnose an issue, and if it needs an operation longer to explain the treatment options, potential risks and complete the paperwork, but, the managers have decided that 10minutes is sufficient.

@FixTheBone - you don't have access to your waiting lists? You don't know who is on your waiting lists? Christ alive

How do you book your lists if you don't mind me asking? Presume your bookers discuss with you about who you want on there, what order you want the list etc? How do you list clinical priority over long waiting patients if you don't know what is on your lists?

I'm trying to think of one specialty or surgeon who doesn't know what is on their own waiting lists and I genuinely cannot. That is really worrying.

For what it's worth....our clinics are 25mins for a new and 15 for a follow up. I don't recognise your '10 mins' as mandated by horrible managers but carry on as you were...

And it's laughable that everything comes back to the managers fault. Honestly.

Who do you think I answer to for my clinic utilisation? My theatre utilisation? The exec team. And who do you think they answer to? The government. The same government who have told us we will be penalised financially for not hitting 110% activity benchmarked against 2019....ie pre covid, with less staff, less money, nursing strikes, doctor strikes, covid outbreaks ongoing and more acutely unwell patients.

Do you really think some band 7 manager is sitting around just coming up with random targets for lols?

I think it's a mixture @fissty. I have had the misfortune to pop to my local hospital for a blood test to see a notice that says 45 min wait. To wait for half an hour and hear people leaving because they have been waiting for 2.5 hours. I've inquired at the desk and been told by two receptionists sitting opposite phlebotomy, who I have heard for 30 mins nattering about everything under the sun, "nah, dunno we're outpatients, nothing to do with us". I've asked then to find out. "Nah, nuffing to do with us". I've asked to speak to the manager - there are apparently three for phlebotomy. I've pressed and someone turns up a bit flustered. Evidently Tuesday's liver clinic day and one of the two phlebotomists have to cover that. I still don't know why the communication about waiting times wasn't updated, but the morning went in to the phlebobotomist who stomped out and slammed a notice saying 3hrs over that for 45 mins.

There appeared very little cognizance of the customer but a lot of non clinical people doing sweet fuck all, except for nattering.

I'd really appreciate if you could please explain the philosophy to a scummy patient whose time appears to be worthless.

As you were "luvvy".

Not a reason to take your anger out on doctors. Honestly I find that disgusting

Agreed @Fiona7656 if it's the government fail it's certainly not the doctors

I’d just like to ask if you are able to switch off when you finish your shift or does your experiences/ decisions you’ve made during the day play on your mind.
Thank you for doing the work you do, my brother’s life was saved by a young doctor in hospital.

Thank you for putting yourself out here.
I and my family would not be here without the NHS, literally, we depend on you, (no pressure then😅)
I'm glad you've chosen this career, even though it's so hard. You want things to be as they should be and are seeing the big picture. You're exactly what the NHS is needing. You must be exhausted. I hope conditions will change so you'll be happy to continue. Good luck with your demands. You can see from the answers that people are behind you.